January 22,2008

Baucus Urges Passage of Indian Health Bill

Finance Chairman led inclusion of key provisions on Medicare, Medicaid, children’s health

Washington, DC – Senate Finance Committee Chairman Max Baucus (D-Mont.) is urging passage of the Indian Health Care Improvement Act, as full Senate consideration of the legislation begins today. In September 2007, Baucus led the Finance Committee in passing a package of provisions to bolster Indian health policies in programs under the panel’s jurisdiction. Baucus’s “Medicare, Medicaid, and Children’s Health Insurance Program Indian Health Care Improvement Act of 2007” will make those programs more affordable and accessible for people living in Native communities. The Finance-passed provisions have been included as part of the larger Indian health package being considered on the floor this week.

“I’ve visited with doctors, nurses, and social workers on reservations in my home state of Montana, and I’ve seen just how dire the health care situation really is there,”
Baucus said. “The provisions we’ve put together in this bill will deliver the essential resources and services that are so desperately needed to save lives in Native communities all across the country. Today, I ask my colleagues to join me in addressing this crisis, and in supporting the Indian Health Care Improvement Act.”

The “Medicare, Medicaid and CHIP Indian Health Care Improvement Act of 2007” provides $52 million in additional funding to improve reimbursement procedures, bolster outreach programs, and eliminate co-payments for patients of the Indian Health Service who rely on programs under the Finance Committee’s jurisdiction. The package also streamlines and updates rules and regulations that will enable federal health programs to work more effectively with the Indian Health Service.

A summary of Baucus’s “Medicare, Medicaid and CHIP Indian Health Care Improvement Act of 2007” follows here. A more detailed section-by-section of the Finance Committee package is
available online at http://finance.senate.gov/.


  • Facilitates Federal Payments to Indian Health Programs. Under current law, only some Indian health programs may be reimbursed by Medicaid, Medicare, and CHIP when they provide services to covered individuals. The legislation expands reimbursement to the full range of Indian health programs, including IHS facilities, Indian Tribes, Tribal Organizations, and Urban Indian Organizations.
  • Improves Medicaid and CHIP Access. The bill improves access to Medicaid and CHIP programs for Indians residing on or near reservations by directing the Secretary of HHS to encourage States to achieve this goal using strategies like allowing program enrollment on or near the reservation, providing program outreach and education for Indian communities, and providing translation services.
  • Increases Outreach and Enrollment of Indians in CHIP and Medicaid. The legislation allows states to exceed the current cap on total CHIP outreach spending to enroll Indian children.
  • Eliminates Cost-sharing and Premiums for Medicaid and CHIP. The bill amends Medicaid and CHIP to exempt Indians from enrollment fees, premiums, deductions, co-payments, cost sharing, or similar charges for those who receive services from the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization. 
  • Authorizes Payment for Services under Federal Health Programs. Some Indian health care providers are not currently licensed under state and local laws. Under this legislation all health care providers operated by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization will be considered licensed for the purpose of federal reimbursement for programs such as Medicare, Medicaid and CHIP, so long as these entities meet generally applicable standards for licensure.
  • Institutes Consultation with Tribes on Federal Health Programs. The bill amends the Social Security Act to establish a Tribal Technical Advisory Group (T-TAG) to help the Secretary identify and address issues affecting Indians in federal health care programs. It also requires States to regularly consult with designees of Indian Health Programs.
  • Exclusion Waiver Authority for Affected Indian Health Programs. This section protects certain healthcare-related transactions between Indian health care programs, which are often necessary as a result of the unique challenges Indian health care providers face in serving this population.
  • Modifies Medicaid Managed Care Entity Rules. The legislation amends Medicaid’s managed care rules to specify actions that States and managed care plans must take to guarantee appropriate payment for Indian health care provider services to Indians in Medicaid and CHIP.
  • Creates an Annual Report on Indians Covered by Federal Health Programs. The bill requires the Secretary to submit a report to Congress regarding the enrollment and health status of Indians receiving items or services under Medicare, Medicaid and CHIP during the preceding year.